2023-00675CITY OF MONTICELLO
505 WALNUT STREET
MONTICELLO, MN 55362-
763) 295-3060 FAX: (763) 295-4404
ADDRESS : 4334 86TH ST NE
PIN : 155264002010
LEGAL DESC EDMONSON RIDGE
LOT 001 BLOCK 002
PERMIT TYPE MECHANICAL
PROPERTY TYPE SINGLE FAMILY -DETACHED
CONSTRUCTION TYPE NEW CONSTRUCTION
NOTE: NEW CONSTRUCTION HOME 12 FIXTURES
NUMBER OF MECHANICAL FIXTURES
APPLICANT
AIR MECHANICAL
16411 ABERDEEN STREET NE
HAM LAKE, MN 55304-
763)434-7747
OWNER
LSW INVESTMENTS LLC
4065 CHELSEA RD W
MONTICELLO, MN 55362-
12.00
AGREEMENT AND SWORN STATEMENT
I agree that the work will be conducted in conformance with
the ordinances of the City of Monticello and with the
Minnesota State Building Code. I understand that the work
will be in accordance with the plan that has been approved by
the Building Official. I agree that any damage caused to
public property including but not limited to curb, sidewalk,
public utilities and signs will be repaired at my expense.
Applicant
Date
Bldg Official Date
2il[ 1311111IIII M IN IN II[II IIIE Iill IN
2 0 2 3— 0 0 6 7 5
DATE ISSUED: 07/31/2023
Permit #: 2023-00675
MECHANICAL BASE FEE, REST 50.00
MECHANICAL FIXTURES 108.00
STATE SURCHARGE, MECH FIX 1.00
TOTAL 159.00
Payment(s)
CHECK 062646 159.00
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Monticello
BUILDING SAEE1 PERMIT # 2QZ3 -6O
505 WALNUT STREET, SUITE 1 MONTICELLO, MN 55362
City Hall (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
SITE ADDRESS: 4334 86th St NE ZONEp
LEGAL: Lot 1 Block 00 Z Plat lm,,,t a P. of y er
Property Owner Name: L s vve T+^ vf5Tr-ne-,, S Phone:
Address: City: State: Zip:
Contractor Name: Air Mechanical Phone: 763-258-3246
State License #: MB005122 E-Mail:ebarton@airmechanical.com
Address: 16411 Aberdeen St NE City: Ham Lake State: MN Zip: 55304
Eng./Architect Name: Phone:
Address: City: State: Zip:
Plumber Name: Phone:
Address: City: State: Zip:
Mechanical Name: Phone:
Address: City: State: Zip:
TviQe of Work Twe of Construction Building Information
El New 1] Single Family Use of building
Addition Duplex of stories
Alteration Q Multi -Family Floor area sq. ft.
Repair Commercial Estimated value
Move Industrial of construction $ 20800.00
Other Other
Description of work:
Residential New Construction
I hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I
agree that the work will be conducted in conformance with the ordinances of the City of Monticello and with the Laws of the State of Minnesota;
and that I understand that this application is not a permit and that the work is not to start without a permit. I further understand that the work will
be in accordance with the plan that has been approved by the Building Official. I agree that any damage caused to public property including but
not limited to curb, sidewalk, public utilities and signs will be repaired at my expense.
SEE BACK FOR PLUMBING
7i21/2023 AND MECHANICAL INFO.
X'poplicant Signature Application Date
APPLICANT. • Please show.frxtures that are applicable.
Fire Suppression : (if applicable) Plu nbi tg: (if applicable) Mechanical. (if applicable)
No. Fixture Tvve No. Fixture Tvue No. Fixture Tvue
Sprinkler Heads Water Closet (toilet) I Furnace
Other/Special FSDevice
14—
2 Bathtub Gas Meter
H Lavatory (wash basin)
L
Range Hood
Shower 1 Gas Range
Kitchen Sink Water Heater
Dishwasher 1 Air Conditioning
Laundry Tub Mech. Fireplace
Clothes Washer 3 Bathroont(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater 1 Air Exchanger
Urinal Dryer
No. Fixture Tvne Drinking Fountain 2 Gas Opening rv/o Fixture
t Floor Drain
i# of Devices Slop Sink
Other Outside Faucet
TOTAL 0 /Z TOTAL
FORt CITY USE ONL.
Future Owner Information: Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address:
City: ADDITIONAL INFORMATION:
Valuation:
State: 7.ip: Construction Type:
Occupancy Group:
Phone #: Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:
Off -Street Parking Uncovered:
uilding Official 7 7 /LYI
PT:
r / /
CITY OF
2 Monticello
BUILDING SAFETY
203-
PERMIT #
505 WALNUT STREET, SUITE I MONTICELLO, MN 55362
City Hall (763) 295-2711 Building Inspections (763) 295-3060 Fax (763) 295-4404
BUILDING PERMIT APPLICATION
Please Print - INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.
SITE ADDRESS: 4334 86th St NE
LEGAL: Lot Block
Property Owner Name:
Address:
Contractor Name: Air Mechanical
State License #: MB005122
Address: 16411 Aberdeen St NE
Eng./Architect Name:
Address:
Plumber Name:
Address:
Mechanical Name:
Address:
Tvpe of Work
El New
Addition
Alteration
Repair
Move
El Other
Description of work:
Residential New Construction
ZONED
Plat
Phone:
City: State
Phone: 763-258-3246
E-Mail: ebarton@airmechanical.com
City: Ham Lake State: MN
City:
City:
City:
Tvve of Construction
0 Single Family
Duplex
Multi -Family
Commercial
Industrial
Other
Phone:
State:
Phone:
State:
Phone:
State:
Zip:
Zip: 55304
Zip:
Zip:
Zip:
Building Information
Use of building
of stories
Floor area sq. ft.
Estimated value
of construction $ 20800.00
I hereby apply for a permit for construction as described and acknowledge that the information I have provided above is complete and accurate. I
agree that the work will be conducted in conformance with the ordinances of the City of Monticello and with the Laws of the State of Minnesota;
and that I understand that this application is not a permit and that the work is not to start without a permit. I further understand that the work will
be in accordance with the plan that has been approved by the Building Official. I agree that any damage caused to public property including but
not limited to curb, sidewalk, public utilities and signs will be repaired at my expense.
SEE BACK FOR PLUMBING
7/21/2023 AND MECHANICAL INFO. eipapi ic`ant Signature Application Date
APPLICANT. Please show,fixtures that are applicable.
Fire Sunvression : (if applicable) Plumbinz. (if applicable) Mechanical. (if applicable)
No. Fixture Tvne No. Fixture TVDe No. Fixture Tvne
Sprinkler Heads Water Closet (toilet) Furnace
Other /Special FS Device Bathtub Gas Meter
Lavatory (wash basin) Range Hood
Shower Gas Range
Kitchen Sink Water Heater
Dishwasher 1 Air Conditioning
Laundry Tub Mech. Fireplace
Clothes Washer 3 Bathroom(s) Exhaust Fan
Fire Alarm: (if applicable) Water Heater 1 Air Exchanger
Urinal Dryer
No. Fixture Tvne Drinking Fountain 2 Gas Opening w/o Fixture
Floor Drain
of Devices Slop Sink
Other Outside Faucet
TOTAL I L TOTAL
FOR CITY USE ONLY
Future Owner Information: Tree Ordinance Handout Yes No
Other Handouts Yes No
Name:
Address:
City: ADDITIONAL INFORMATION:
Valuation:
State: Zip: Construction Type:
Occupancy Group:
Phone #: Division:
Square Footage:
of Stories:
of Residential Units:
Maximum Occupancy:
Fire Sprinklers: Yes No
Off -Street Parking Covered:
Off -Street Parking Uncovered:
Building Official
BPT: / /